Preface to Part 2:
Obviously it has been a long time since I have made a blog post...I first want to finish this birth story and describe how this birth has molded and changed my perspective as a student midwife. The birth of Baby "J" was the first out-of-hospital birth I ever attended and ended up launching me back into the realm of midwifery itself. I was serving Ginger as her doula. My inexperience is obvious to me now looking back, but at the time I was so wrapped up in the emotion of caring for Ginger and Scott and their unborn baby...all knowledge of obstetrics was unimportant to me.
Prior to attending this birth, I had a very idealistic view of out-of-hospital birth. I thought that doctors were the enemy and should be avoided and used as a last resort. Boy, was I wrong! It is a wise-woman, indeed, who sees a problem coming before it arises and heads it off...not willing to wait until lives are at risk to do something about it.
Now that I have attended more out-of-hospital births, I understand more clearly that one should not be attached to the birth setting, but instead be attached to a good outcome regardless of where it is. It is proper that a low-risk birth should proceed at home (or in another out-of-hospital setting) as long as everything remains low-risk and normal. When something outside of normal limits arises, it then becomes necessary to move into the hospital setting, and thanks be to God that we live in a time when medical doctors and technology allow for the possiblity of a good outcome even in the face of major challenges! Most of the time a transport to the hospital is done in a non-emergent way, as was the case for Ginger and Scott, but on rare occasions a true emergency arises which necessitates immediate transport.
Technology has it's place in the birth world...to save lives when things deviate from normal and become life-threatening. Midwifes are the guardians of normal. Obstetritians are the heros of high risk and abnormal. There is a place for both professions, and when they are able to work together in a proper balance to pursue the best possible outcome for each individual woman with child, women are able to have better birth experiences.
I have been apprenticing as a midwife for almost a year now, so my perspective and knowledge of birth has increased but is, by far, not yet complete. Each birth teaches me so much! Each mother and child has their own lessons to offer me...I soak up each experience and allow it to form me as a midwife. It has been a year since Baby "J" was born, and I have reflected many times on the events of her birth...
After repeating herself about her concern, the midwife received a positive response from Scott that it was okay for them to transport, so she began to get their charts and things ready to leave. As I knelt there in front of Ginger, I talked to her, as best I could, telling her how she had done everything right...that this was not any "failure" on her part and that this is what the hospital was there for: to assist when complications arise. I can't remember exact phrasing, but everything seemed suitable for the time, and I hope that it brought comfort and strength to her and Scott. After my attempt at encouraging "doula" remarks, I held her knees and cried with them. This was the first of many tears we would shed together...not all of them out of sadness. We all had to take time to process this news. It was a learning curve for me too. I realized that I had been holding just as high of expectations that everything would go perfectly.
I rode in the car with Ginger as Scott drove, following the midwife to the hospital. Mostly, my job was to try to keep the atmosphere relaxed and help Ginger through any contractions she had on the way. Thankfully for her, she only had a couple.
By the time we arrived at the hospital, Ginger's contractions had spaced out a little, which was welcomed by her since they had been so long and intense before we left the birth center. We took her in by wheel chair so that she wouldn't have to walk and stop with every contraction. She was very nervous. She was also very concerned about her birth plan for a cesarean. I kept reassuring her that transport does not necessarily equal cesarean and that we would cross that bridge if the time came.
Once we were assigned a room and Ginger's I.V. was going, she suddenly perked up. She was chatting with Scott and even laughing! They were telling me and the midwife stories, and the mood began to lift. This was reassuring after what had been going on previously...it was nice to see Ginger get a second wind! We all thought that this may have been exactly what she needed --a break from a very intense labor.
Eventually, contractions began again and we suggested that she do another "rotation" to see if the baby would turn to a better position. No change.
The doctor and nurses suggested an epidural and therapeutic sleep. After much discussion between Ginger and Scott, and some input from myself and the midwife, they accepted this comfort measure and we all took a much needed nap.
We all hoped that she would see some progress in cervical dilation after these hours of rest, but, alas, no change again.
Finally, after about 7 or 8 hours of no progress (or was it 11 hours?) the doctor gave her "the talk". He let her know that at the moment, baby was fine, but if this pattern of lots of contractions and no progress kept up, eventually the baby would not be able to tolerate it and would begin to get distressed. He made it clear that she could choose to have a cesarean now while there was time to be relaxed about it, or she could wait until it became an emergency situation. He gave her a time limit (maybe 30 minutes) and said if there was still no change after that point, he would highly recommend a cesarean.
We all prayed so fervently for that entire time period! Each contraction Ginger had, we would pray and all say aloud that her cervix was opening, and that, if it were God's will, she would be able to give birth vaginally.
When the news came that her cervix had still not changed she was so deflated. She and Scott let the staff know that they would consent to a cesarean, so the paperwork began. While the nurses left the room to get things set up, Ginger asked me, "Does God not hear us? How can this be happening?" (or something to that effect). I responded by giving her the example of Jesus praying in the Garden of Gethsemane. He asked God to spare him from the torcher he was about to endure...and that if it was at all possible, that he would not have to endure it. It may have seemed that God was ignoring him, but, in fact, He had bigger plans. Jesus had to endure that tremendous suffering and death, but God then raised him from the dead!! The guy stinkin' came back to life into his original body and amazed everyone! Not to mention that by his suffering and death, Jesus also accomplished the ultimate attonement for the sins of all mankind!
**When someone puts their entire faith and life into the hands of God, it is a very vulnerable state of being. It is easy to feel let down when things do not turn out the way we want them to. But sometimes, God's plan is bigger than ours...Ginger has since then begun a fabulous journey in becoming a doula and will be able to comfort and inspire many women during their birth times. She had a long road of healing but decided to be proactive and follow a calling that, she feels, has been placed on her because of the experience she had birthing Baby "J".**
So, back to the cesarean...I gave Ginger as many positives to think about as I could before they came to take her back to the OR. At one point, the doctor told a very inappropriate story of how a large (13lb.) baby had died after a cesarean birth recently...at which point I had to do damage control on poor Ginger's psychy. Why would he tell such a story in front of a pregnant mother about to go under the knife?! I can only assume that he just didn't think before he spoke...he was telling the story to the midwife, so I'm sure he was just caught up in the moment.
They took Ginger back and got Scott all scrubed up. I was not allowed to go back with her, but I sent my camera with Scott so they could have pictures of their first moments with their baby. I waited for what felt like eternity for the nurses to tell me that she was okay and the baby had been born healthy. Scott came out and told us he had a new daughter!!! I gave him the biggest hug ever and we both were crying, only this time they were tears of joy!
As it turns out, Baby "J" weighed 9lbs. 7oz. and was completely posterior. Ginger, being the whole 5'1'' tall that she is, says she wonders how Baby "J" fit in her tummy: ) If the baby would have just been large or turned posterior, the outcome may have been different, but the combination of the two made vaginal delivery impossible this time.
The doctor reassured her that he did the proper incision and stiching to allow for a VBAC with her next pregnancy as long as the births were 24 months apart. This was at least a comforting thing to hear...that she wasn't sentenced to a cesarean next time.
I was able to go into the recovery room and visit with Ginger for a little while. We hugged and I adored Baby "J" for a long time. I felt so connected to all of them! It felt as thought they were my family, too. I wanted to stay a bit longer, but I knew she needed rest and still had a waiting room full of family members eager to meet their newest addition. **I had been going out to give updates and photos to the family periodically, per Ginger's request. I was the closest they could get to being with Ginger...the nurses would not take time to relay information back and forth to the family.** This birth is still, to this day, the most emotional birth I have ever attended. We will forever have a special relationship that nothing will ever be able to take away. This family is eternally imprinted on my heart.
Ginger was very nervous to tell her friends about her birth experience because she was afraid of being viewed as a failure. More specifically, she was afraid of the naysayers who had been opposed to her out-of-hospital birth greeting her with comments of "I told you so..." and such. But Ginger did not have an unsuccessful out-of-hospital birth. On the contrary, she had a very successful one: she was under supervision of a well trained midwife who was the "guardian of normal" for the birth. When things got out of the realm of normal limits, the midwife recognized it, made sure there was informed consent and took the appropriate measures to get Ginger and her unborn baby to be able to recieve more advanced observation and assistance to keep mom and baby healthy. Baby was born healthy, and Ginger remained healthy. This was a good outcome to an out-of-hospital birth plan. Unnecessary intervention was successfully avoided, and only necessary interventions were performed under truely informed consent.